A Pragmatic Approach for Managing Unexplained Neutropenia in a Brain Tumor Patient

Abstract

Cancer patients experience a decrease in blood counts either due to the myelosuppressive effect of oncological treatment or bone marrow infiltration due to distant metastases. Oncological interventions, such as chemotherapy, immunotherapy or large-field irradiation, are common causes of neutropenia, thrombocytopenia, or pancytopenia in cancer patients. Non-oncological reasons for the decrease in blood counts can be attributed to drug-induced, autoimmune diseases, or viral infections. Recently, case reports have been published for neutropenia/thrombocytopenia due to the Coronavirus disease (Covid-19) pandemic too. Here, we discuss a case of phenytoin-induced neutropenia in a brain tumor patient and a pragmatic approach for managing unexplained neutropenia, that is, neutropenia unrelated to cancer or oncological intervention. Timely recognition and timely intervention can prevent fatal outcomes.